Development and application of health outcome descriptors facilitated decision-making in the production of practice guidelines.

Clinical Decision-Making / methods Evidence-Based Medicine / standards Fibrinolytic Agents / standards Humans Outcome Assessment, Health Care / standards Practice Guidelines as Topic / standards United States Venous Thromboembolism / diagnosis
Clinical decision-making Clinical practice guidelines GRADE Health outcomes Health recommendations

Journal

Journal of clinical epidemiology
ISSN: 1878-5921
Titre abrégé: J Clin Epidemiol
Pays: United States
ID NLM: 8801383

Informations de publication

Date de publication:
10 2021
Historique:
received: 11 11 2020
revised: 06 04 2021
accepted: 21 04 2021
pubmed: 17 5 2021
medline: 30 11 2021
entrez: 16 5 2021
Statut: ppublish

Résumé

Stakeholders involved in developing recommendations need to have a common understanding of health outcomes and the perspective of affected individuals. In this paper we report on the development and application of health outcome descriptors (HODs) to inform decision-making by panels developing guideline recommendations. Ten American Society of Hematology guideline panels addressing the management of venous thromboembolism developed HODs, rated their importance and health utility, applied them to prioritize outcomes, and to balance potential benefits and harms to formulate recommendations. It was feasible to involve 18 panelists in developing 127 HODs. There was high agreement (82%) across the ten panels about outcomes perceived as critical or important for decision-making. Panelists' utility ratings of the outcomes were strongly correlated with panelists' outcome importance ratings (Pearson's r=-0.88). HODs were incorporated into Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence-to-decision (EtD) frameworks to support a shared understanding of health outcomes in panel deliberations. HODs serve as a valuable tool to promote an explicit, common understanding of health outcomes during clinical guideline development and across different stakeholders. They are helpful across multiple steps of guideline development to facilitate panels' judgements, aiming to avoid variable implicit interpretations of health outcomes.

Identifiants

DOI: 10.1016/j.jclinepi.2021.04.016 PMID: 33992716
pubmed: 33992716
pii: S0895-4356(21)00139-6
doi: 10.1016/j.jclinepi.2021.04.016
pii:
doi:

Substances chimiques

Fibrinolytic Agents 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

115-127

Informations de copyright

Copyright © 2021 Elsevier Inc. All rights reserved.

Auteurs

Wojtek Wiercioch (W)

Michael G. DeGroote Cochrane Canada & McMaster GRADE Centres, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.

Robby Nieuwlaat (R)

Michael G. DeGroote Cochrane Canada & McMaster GRADE Centres, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.

Philipp Dahm (P)

Urology Section, Minneapolis VA Health Care System, Minneapolis, MN, USA; Department of Urology, University of Minnesota, Minneapolis, MN, USA.

Alfonso Iorio (A)

Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada.

Reem A Mustafa (RA)

Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada; Department of Medicine, Division of Nephrology and Hypertension, University of Kansas Medical Center, Kansas City, KS USA.

Ignacio Neumann (I)

Department of Internal Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.

Bram Rochwerg (B)

Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada.

Veena Manja (V)

Department of Surgery, University of California Davis, CA, USA; Department of Medicine, Veterans Affairs Northern California Health Care System, Mather, CA, USA.

Pablo Alonso-Coello (P)

Iberoamerican Cochrane Center, Biomedical Research Institute Sant Pau (IIB Sant Pau-CIBERESP), Barcelona, Spain.

Thomas L Ortel (TL)

Departments of Medicine and Pathology, Duke University Medical Center, Durham, NC, USA.

Nancy Santesso (N)

Michael G. DeGroote Cochrane Canada & McMaster GRADE Centres, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.

Sara K Vesely (SK)

Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

Elie A Akl (EA)

Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada; Department of Internal Medicine, American University of Beirut, Lebanon.

Holger J Schünemann (HJ)

Michael G. DeGroote Cochrane Canada & McMaster GRADE Centres, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada; Institut für Evidence in Medicine, Medical Center & Faculty of Medicine, University of Freiburg, Freiburg, Germany. Electronic address: schuneh@mcmaster.ca.

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Classifications MeSH

questionsmedicales.fr › Diagnostic › Prise de décision clinique › Development and application of health outcome...
questionsmedicales.fr › Professions de santé › Médecine › Médecine clinique › Médecine factuelle › Development and application of health outcome...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents hématologiques › Fibrinolytiques › Development and application of health outcome...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Development and application of health outcome...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Development and application of health outcome...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Assurance de la qualité des soins de santé › Recommandations comme sujet › Guides de bonnes pratiques cliniques comme sujet › Development and application of health outcome...
questionsmedicales.fr › Régions géographiques › Amériques › Amérique du Nord › États-Unis › Development and application of health outcome...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Embolie et thrombose › Thromboembolie › Thromboembolisme veineux › Development and application of health outcome...